Nevada Medicaid and Nevada Check Up News (Fourth Quarter 2022 Provider Newsletter) [Read]

Attention Behavioral Health Providers: Monthly Behavioral Health Training Assistance (BHTA) Webinar Scheduled [See Web Announcement 2009]

Attention All Providers: Requirements on When to Use the National Provider Identifier (NPI) of an Ordering, Prescribing or Referring (OPR) Provider on Claims [Announcement 850]

If you are a Medicaid provider whose revalidation application has not been processed by your termination due date, you will be ineligible to provide services to any Nevada Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. See Web Announcement 1265

Enrollment Termination Frequently Asked Questions (FAQs) [Review]

Notifications


Attention AuthentiCare® Nevada users: Claims submitted using the Electronic Visit Verification (EVV) solution AuthentiCare® Nevada during the week ending January 13, 2023, will be delayed by one week due to a claims processing issue. Claims that should have paid on January 20, 2023, will be paid on January 27, 2023. The impacted provider types are 30 (Personal Care Services – Provider Agency), 48 (Home and Community Based Waiver for the Frail Elderly), 58 (Home and Community Based Waiver for Persons with Physical Disabilities) and 83 (Personal Care Services – Intermediary Service Organization).

Nevada Medicaid COVID-19

Nevada Health Response

Known System Issues-Click HERE

Paper claims are no longer accepted by Nevada Medicaid. Please refer to Web Announcement 1733 and Web Announcement 1829 for additional information.

Top 10 Claim Denial Reasons and Resolutions/Workarounds for December 2022 Claims. See Web Announcement 2985.

Top Prior Authorization Denial Reasons for the First Quarter of 2021. See Web Announcement 2505.

Top 10 Enrollment Return Reasons and Resolutions for First Quarter 2021 Submissions. See Web Announcement 2501.

Attention Providers Using the Authorization Criteria Function: Results that return prior authorization (PA) requirements are accurate. For results that return “There are no records found based on the search criteria,” there may be a PA requirement if limits have been exceeded. To verify PA requirements, please refer to the Medicaid Services Manual (MSM) Chapter for your service type at dhcfp.nv.gov and the Billing Guide for your provider type at www.medicaid.nv.gov.

Scheduled Site Maintenance

During the scheduled site maintenance window the Provider Web Portal will be unavailable. The table below shows the regularly scheduled maintenance window. All times will be in the Pacific time zone.

Monday - Friday
12:00AM - 12:30AM

Monday
8:00PM - 12:00AM

Contact the Provider Training Unit

Provider Relations Field Service Representative Team Territories: Please refer to the attached document to determine which Field Representative is assigned to assist you with inquiries.


Nevada Medicaid and the Division of Health Care Financing and Policy (DHCFP)/Nevada Medicaid are committed to helping providers understand:

  • Medicaid policy,
  • claims submission,
  • the enrollment process,
  • authorization submission, and
  • other processes to ensure successful interaction with the Nevada Medicaid program.


With these priorities in mind, Nevada Medicaid offers opportunities to increase your knowledge throughout the year in a variety of formats and times, including instructor-led virtual training, instructional videos, computer-based training materials, and reference documents such as Frequently Asked Questions (FAQs) and Tip Sheets.


Training is free of charge and billing staff, billing agencies, direct practitioners/health care providers, office managers, admitting and front-desk staff, etc., are encouraged to attend. Provider training and workshop schedules are posted monthly in a Web Announcement and on this webpage. Registration is required to attend the scheduled instructor-led training sessions. To register, simply select the Provider Training Registration Website link below, select the training session of your choice, complete the required information and submit.


If you have difficulty registering, please send an email to the Provider Services Field Representative Team at NevadaProviderTraining@gainwelltechnologies.com. Please include your name, contact information, and the workshop you are attempting to register to attend. A Field Representative will contact you to assist with the registration process.


In addition to the training sessions and workshops scheduled throughout the year, Provider Services Field Representatives are available to assist when you have questions, concerns or additional training needs. Field Representatives cannot tell you how to bill your claims or specific details to enter into enrollments and authorization requests, but can assist in identifying the causes to issues you are facing in these areas and help provide direction to resources. Please do not hesitate to reach out to your Field Representative as the need arises. If you are unsure who your representative is, please select the Provider Relations Field Service Representative Team Territories link.

Training Calendar and Registration
Title
Training Calendar
Provider Training Registration Website
Training Announcements
Updated Date Title
Jan. 18, 2023 Attention All Providers: Upcoming Training Sessions for February 2023
Dec. 21, 2022 Attention All Providers: Upcoming Training Sessions for January 2023
Aug. 12, 2022 Attention All Providers: Provider Enrollment Group Training Videos Available
Feb. 3, 2022 Attention All Providers: Reminder Regarding Training Options
July 7, 2020 Attention All Providers: Training Calendar Reminder
Jan. 16, 2020 Provider Relations Field Service Representative Team Territories Update
Self-Paced Training

Self-paced, computer-based training courses available on demand for providers.

Group Code Training Portal
PROV Nevada Medicaid Training Portal
Date Topic
January 2022 Learning Management System (LMS) Tip Sheet

Date Topic
August 2021 Nevada Medicaid YouTube® Training Channel

Serious Occurrence Report (SOR) Form Instruction Video
Provider Enrollment and Revalidation Instruction Materials
Date Topic
August 2019 Enrolling as an Individual Provider with Nevada Medicaid
August 2019 Enrolling as a Group with Nevada Medicaid
August 2019 Revalidating as an Individual Provider or Updating an Individual Provider’s Profile with Nevada Medicaid
August 2019 Revalidating a Contract or Updating a Profile as a Group Provider with Nevada Medicaid
August 2019 Enrolling as an Ordering, Prescribing or Referring (OPR) Provider with Nevada Medicaid
September 2019 Enrolling with Nevada Medicaid – Out-of-State Urgent/Emergency Individual Application
September 2019 Enrolling with Nevada Medicaid – Out-of-State Urgent/Emergency Group Application
Provider Tip Sheets, Quick Reference Guides and FAQs
Date Topic
January 2023 Ordering, Prescribing and Referring Provider Enrollment Frequently Asked Questions (FAQs)
November 2022 WebEx Troubleshooting for Nevada Medicaid Providers - Tip Sheet
November 2022 Nevada Medicaid New Provider Resources - Tip Sheet
July 2022 Prior Authorization for Dental Services in an Inpatient Facility - Tip Sheet
July 2022 Prior Authorization for Dental Services in an Outpatient Facility - Tip Sheet
April 2022 Electronic Verification System (EVS) Frequently Asked Questions (FAQ)
January 2022 NVMedicaid Application (Digital Recipient Medicaid ID Cards) Provider Quick Reference Guide
July 2021 Submitting Claims with Other Insurance Frequently Asked Questions (FAQ)
May 2021 Prior Authorization Quick Reference Guide
March 2021 Provider Type 29 (Home Health Agency and Private Duty Nursing Services) Prior Authorization (PA) Frequently Asked Questions (FAQ)
March 2021 Submitting an Institutional Claim for Medicare Part B Coverage - Tip Sheet
October 2020 Claim Submission Tip Sheet: Dental Claims
October 2020 Claim Submission Tip Sheet: Institutional Claims
October 2020 Claim Submission Tip Sheet: Professional Claims
September 2020 Member Focused Viewing Function Quick Reference Guide
August 2020 Verifying A Recipient’s Eligibility Quick Reference Guide
February 2019 Tip Sheet for Claims Appeals
Workshop Materials

Workshop materials will be posted to this site upon completion of the workshop.

Date Topic
July 2021 PASRR, Level of Care (LOC) and Nursing Facility Provider Training
May 2021 Submitting Secondary Claims to Nevada Medicaid Training Video (EVS User Manual Chapter 3: Claims)
June 2020 Nevada Provider Training – Institutional Claims
June 2020 Nevada Provider Training – Professional Claims
May 2020 Telehealth Provider Training during the Novel Coronavirus (COVID-19) Pandemic | Nevada Medicaid Novel Coronavirus (COVID-19) Resources and Contact List
February 2020 Electronic Verification System (EVS) Frequently Asked Questions (FAQ)
February 2020 The Life of a Claim Provider Training
July 2019 National Drug Code (NDC): Billing for Physician Administered Drug (PAD) Claims
September 2018 PASRR and Nursing Facility LOC Frequently Asked Questions (FAQs)
June 2016 Nursing Facility Tracking Form Validation Guide
March 2015 Instructions for Requesting Roles, Approving Roles and Removing Users in the PASRR Web Portal